Whether you take the USMLE or the COMLEX you receive a 2 digit and a 3 digit score.

The 3 digit score is comparable across several different administrations of the exam. For example, a score of a 205 in the Summer of 2008 is comparable with someone who also received a 205 in the Summer of 2007. It is the score used by most residency directors when evaluating applicants.

The 2 digit score is not a percentile or a percentage. The 2 digit score is only relevant in the pool with which you took your exam. The NBME (group that administers the USMLE) reports that they are required by some licensing authorities to have a 2-digit score where the minimum passing score is a 75. Because of this the 2-digit score is not comparable between different test administrations. In other words a score of 81 in the Summer of 2008 is not necessarily the same as a score of 81 in the Summer of 2007. Also, on the USMLE, a 2-digit score of 99 correlated with a 234 or above. Certainly there is a difference between a 234 and a 244, but both received a 99 (further diminishing the usefulness of the 2-digit score).

USMLE (Step 1): more info about scores
The USMLE is the licensure exam administered for all medical students (required for allopathic students). It is administered by the NBME.

Most 3-digit scores fall between a 140 and 260. The minimum passing 3-digit score is a 185 and the average is between a 200 and a 220 (standard deviation of 20).

The 2-digit score is not a percentile. The minimum passing score is a 75.

The USMLE does not report percentiles (again the 2-digit score is not a percentile or a percentage).

You may also want to see the 2007 USMLE Performance Data for more interesting information.

COMLEX (Level 1): more info about scores
The COMLEX is the licensure exam required for all Osteopathic Medical Students and is administered by the NBOME. They also release a 3-digit and a 2-digit score.

The minimum passing 3-digit score is a 400 and the mean is a 500. The standard deviation varies between years but the most recent was a 79.

Similarly to the USMLE, the minimum passing 2-digit score is a 75. The most recent standard deviation was a 3.95. The 2-digit score is not a percentage or a percentile.

The COMLEX does not report a percentile.

A new version of the software used to deliver the computer-based USMLE Step examinations is scheduled to be introduced in mid-August 2008. Migration to the new version will occur first in the Step 2 Clinical Knowledge (CK) examination, and will be phased in over several weeks. If you plan to take the Step 2 CK examination in August 2008 or later, you should familiarize yourself with both the current test delivery software and the new version.

Orientation and practice materials using both the current and new versions of the software are available for downloading:
http://www.usmle.org/Orientation/2008/menu.html

The change to the test delivery software will be accounted for in scoring the examination results, so that scores will be comparable to those of exams using the older software. Because of this change, it will be necessary to delay the reporting of scores for some examinees. The normal turnaround time for reporting scores to Step 2 CK examinees is 3 to 4 weeks. However, during this transition, turnaround time may be as long as 6 to 8 weeks.

Note to Step 1 and Step 3 examinees: Migration of Step 1 and Step 3 to the new test delivery software will occur in 2009. Please monitor the USMLE website announcements section to check for changes in test delivery software, and to access orientation and practice materials.

The following is the official update list for the 1st Ed of the First Aid Q&A for the USMLE Step 2 CK Errata. This list does not include suggestions/additions submitted and accepted for the text.

Download the up-to-date list: PDF - 7/09/2008

1. Page 7
   1. Question 13: The patient’s sodium level should be 134 mEq/L, rather than 34 mEq/L.
   1. Question 14: The patient’s glucose level should be 133 mg/dL, rather than 33 mg/dL.
2. Page 17
   1. Question 50: The question should read, “What is the reasoning behind avoiding nonselective B-blockers in this patient?”
3. Page 41
   1. Question 50: The third sentence should start, “Nonselective B-adrenergic blockade…”
4. Page 139
   1. Question 36: The newborn is a boy, not a girl.
5. Page 169
   1. Question 14: The third sentence should read, “Pathologic examination reveals a population of atypical mononuclear cells infiltrating the dermis and epidermis.”
6. Page 179
   1. Question 51: the bleeding time should be 4 minutes, not 4 seconds.
7. Page 187
   1. Question 14: CTCL involves T (rather than B) lymphocytes.
8. Page 216
   1. Question 24: The next-to-last sentence should be deleted; image was deleted in press so no “physical examination findings are shown below.”
9. Page 236
   1. Answer 24: The correct explanation should not refer to an image.
10. Page 271
    1. Answer 10: The correct explanation should not refer to an image.
11. Page 301
    1. Answer 9: The last sentence should read,”… but the majority of cases of dementia are not reversible.”
12. Page 486
    1. Answers 45 and 46: The correct answers should be switched, K is correct for answer 45 and D is correct for answer 46.

The new errata for First Aid Q&A for the Step 1 are now available for download as a pdf and listed here.  For updates to previous editions, please visit the Q&A for the USMLE Step 1 Archives page.  The following pages received updates:

1. Page 28
2. Page 165
3. Page 176
4. Page 223
5. Page 322
6. Page 328
7. Page 430
8. Page 470
9. Page 548
10. Page 556
11. Page 571
12. Page 586
13. Page 591

We at the USMLERx team have one singular goal: to continue to improve both the quality of questions in our question bank and the manner in which those questions are presented to you. With this in mind, here are some exciting new features on our Web site that are sure to enhance your board preparation experience:

1. Half-day or full-day exam simulation. Now you can simulate an actual half-day or full-day exam on USMLERx.com. You can create either a partial simulation, with four blocks of fifty questions per block, or a complete simulation consisting of seven blocks of fifty questions per block. (To do so, you must have enough unused questions in the bank to create these simulations.) Once questions are placed in Simulation Mode, they will not be available for regular test use on the Web site. As with regular tests on Step 1 Qmax, you will have the ability to continue after each block or suspend the simulation for later. Each block in a simulation will have a separate Analysis Page, and at the completion of each simulation, an Overall Analysis Page will be available for your review. This new feature will allow you to track your progress.
2. Review Question Page. The questions you annotate for review will now be listed on the Review Question Page with links to the actual questions. All you need to do is click on the date link next to a given question, and a new window will open with your question(s) for easy review.
3. More specific options for creating tests. You can now create a test with both an organ system and a discipline, making testing more defined. We have also focused the correct/incorrect question use. You can create tests using ONLY incorrect questions. Watch your incorrect question count go down as you get each question right!

So the Big Day has finally come. How can you maximize your chances of doing well? Here are some basic do’s and don’ts.

1. Double-check your paperwork. Do you have your driver’s license or another signed photo ID? And do you have your orange scheduling permit? Don’t leave home without it!
2. Leave your gizmos behind. The USMLE Bulletin of Information has a long list of electronic gadgets that you can’t bring with you into the testing area. These include cell phones, calculators, pagers, PDAs, radios, recording devices, and, as of the 2008 Bulletin, watches of any kind (both digital and analog). Other items you’ll have to live without - or store in a designated locker or cubicle - include books, notes, scratch paper, and, as of the latest Bulletin, earplugs.
3. Bundle up. Although you can’t bring outerwear such as coats and jackets into the testing area, you should wear warm, comfortable clothing to accommodate variable temperatures at the test site.
4. Show up early. Try to make sure you arrive at your designated testing center about 30 minutes before your scheduled appointment. If you get there any earlier than that, you’ll run the risk of stressing out. Whatever you do, however, don’t get to the testing center late, as you will likely have to reschedule.
5. Chill out! Bearing in mind how hard you’ve worked to prepare for this test, focus on being mentally alert. Focus and avoid panic.

Wondering if the USMLERx Qmax is really worth all that time and investment?

Trying to figure out how best to incorporate your First Aid text into your board preparation?  Check out this article to find out how one USMLERx subscriber prepared for his boards and ended up scoring a 260/99 on the USMLE Step 1!

Hoon Choi is a medical student at Auckland Medical School in New Zealand. He made choices just like you did, or will do, about how to prepare for his board exam. Initially, Hoon chose to use First Aid for the USMLE Step 1 as his primary resource for Step 1 preparation, assiduously underlining the information he felt was particularly high yield. “However, [I found it] difficult to retain the information just by reading and underlining,” says Hoon. So he purchased the USMLERx Step 1 Qmax to help him retain the information he had underscored in his First Aid for the USMLE Step 1 text.

Hoon began preparing for the Step 1 exam five months before he was scheduled to take it. His preparation actually began when he first entered medical school and started to attend his classes and lectures. He studied approximately five hours each day for those five months. And with the help of his classes, lectures, First Aid text, and Step 1 Qmax, Hoon walked into the exam feeling truly prepared.

“The exam was not easy by any means,” Hoon said. “However, the questions were definitely reasonable, and the level of difficulty was not unexpected. I finished the exam feeling like I gave it all I had.”

Here are some of Hoon Choi’s words of wisdom for those of you preparing for the Step 1 exam:

“Attend your lectures, and learn the school material well. Purchase your [First Aid] book six to nine months before your set exam date, and start annotating in your book. Make it your own! Do as many questions as you can get your hands on. When you feel like you’ve done enough questions, do some more. You won’t have time to work through questions when the clock is ticking. You should be familiar with the material enough to be able to ‘react’ when the clock is ticking.”

The following is the official update list for the 2008 Ed of the First Aid for the USMLE Step 1 text. For a complete list of all updates to this edition, please visit the Step 1 Corrections page.

Download the updates list. (word) (PDF)

The First Aid Team is looking for a motivated student to take over the responsibilities of running www.firstaidteam.com! Send an email with a resume to us at firstaidteam@yahoo.com

The Job

1. Year long commitment to managing the content of this blog, including working with members of other projects to publish updates to various editions of the First Aid texts.
2. Independently researching issues affecting students studying for the Boards and creating timely blog posts (NBME website, ECFMG, student forums, etc.)

The Perks

1. Authorship credit in the First Aid for the USMLE Step 1
2. Generous stipend
3. Opportunity to work with First Aid authors and develop relationships for future projects

The Applicant

1. Passionate about medical education and helping fellow students
2. Comfort with HTML, Wordpress, Excel, Adobe Acrobat, Word
3. Experience blogging a big plus!
4. Basic ability in image editing
5. Organized, dependable, and able to work with a team.

This announcement from USMLE.org

A small number of multiple-choice items with associated audio and/or video clips will be introduced into the USMLE Step 1 Examination beginning in mid- to late May 2008. No more than 5 items with associated media clips will appear in a single examination. The 2008 USMLE Orientation Materials include a small number of multiple-choice items that contain exhibits involving audio and/or video clips. Instructions for practicing with items with associated media clips on Step 1, Step 2 CK, and Step 3 are provided in the Tutorials for each Step examination in the orientation materials.

Items with associated media were introduced into Step 2 CK in 2007, and into Step 3 in March of 2008. As of May 2008 all three multiple-choice question components of the USMLE examination will include items with associated audio and/or video.